David Unwin is a primary care physician in the UK. For the last eight years he’s been running a long term cohort study in his clinic, in which he treats his diabetic patients with a low carb diet. The study has generated massive amounts of useful data on what happens when patients with type 2 diabetes switch to a low carb diet. And the results have been pretty astounding, with patients going in to complete remission from their diabetes (something which was previously thought to be virtually impossible), lowering their blood pressure, improving their cholesterol levels, losing weight, improving their liver and kidney function, and being able to go off drugs that they would otherwise likely have had to stay on for the rest of their lives.
In this podcast, I talk to David about how the study came about and what the low carb intervention that he gives his patients consists of more specifically. We then discuss some of the common criticisms of the low carb diet and why they really aren’t supported by the scientific evidence, and end with a discussion of what doctors and other clinicians who are interested in implementing a low carb diet with their patients can do to make it happen. I enjoyed this conversation a lot and I hope you will too.
You can watch the interview here.
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Hi Sebastian,
I think this post ties in well with your former post on how to loss weight rapidly by focusing on increasing protein and fibre proportions in your diet. However you said one need not do keto unless you’re diabetic. I was wondering how does that idea fit in with the carbohydrate-insulin model of obesity – Should one try their best to keep carbs so low to keep insulin spikes low as insulin is anabolic for both fat and muscle? How about some carbohydrates from an exercise endurance and muscle growth point of view?
On another note the keto diet does seem to increase LDL, but do you think this is not clinically significant issue?
I think the situation may be different for professional athetes. Their heavy levels of physical activity mean they can tolerate a much higher carbohydrate load than the average person.
As discussed in other places on this blog, for example in the interview with Malcolm Kendrick, I don’t think LDL is an issue. And even if it was, that would need to be weighed against all the other things that go in the right direction with a low carb diet.
Hi Sebastian
I pay a monthly fee for the patron membership – and today get a
Sebastian Rushworth M.D.’s new patron-only release: “The low carb cure, with
Then apparently the same article appears on your open page. What is my subscription buying me please? Or is it’s purpose just to support you financially – that’s fine – I would probably do it anyway – but when I get a “patron only release” I assume it’s something special.
Patrons get the full length version of the interview. Non-patrons get a cut down version, that is about half as long.
Have I recommended my high toffee diet?
If after the main course at dinner or lunch you fancy a sweet course, don’t! Avoid, say, 80 g of carbohydrates; instead chew a toffee – 8 g of carbohydrates.
Well no shit Sherlock
I have been following the Dr. Richard K. Bernstein diabetes protocol since 2008.
I am still insulin-dependant however, only need 2-3 units of fast-acting insulin for meal coverage and have normalized my BG to non-diabetic values at around 84-86 mg/dL [4.6-4.7 mmol/l] and an HBA1C ~ 4.6%-4.9%. after a year I reversed the complications I had.
His main diet recommendations are maximum of 6 g of carb for breakfast and 12-12 g for lunch and dinner. It not only works to control Blood glucose but I lost 40 lbs of mass in 3 months on his low-carb diet.
He is truly THE pioneer in this treatment method.
See:
Revised edition published in 1997, DR. BERNSTEIN’S DIABETES SOLUTION is a unique resource that covers both adult- and childhood-onset diabetes, explains step-by-step how to normalize blood sugar levels and prevent or reverse complications, and offers detailed guidelines for establishing a treatment plan.
Thank you once again Dr Rushworth. Diabetes is the real pandemic…
Even for me who is not diabetic I strongly believe this is a healthy diet. I reduced my BMI from 26 to 20-21 in about a year by reducing carbs and eating less (as an effect of feeling more satisfied)
Its remarkable how hungry you get from eating a “normal” high carb diet and how easy the kilos come back.
Id like to ask the community here for some ideas… How can a person that is intolerant to egg/dairy plus being vegetarian follow a low-carb diet?
It seems the diet becomes way too restrictive from only eating salads, goats cheese and fish+seafood…
Drop the “being vegetarian”. If you suspect there’s some truth in the argument that we should eat like our Mesolithic predecessors, eat fish, fowl, and mammals.
If you’re eating fish you’re not a vegetarian. Go the whole hog and fry yourself some bacon.
Ideally yes… Good quality meats are excellent sources of nutrion.
The question is not for me but rather related to my efforts in trying to spread the word about low-carb diets. Also, I saw another comment here to avoiding red meat. (true or not).
A lot of people are already on a restrictive diet for whatever reason, and restricting it further (to low-carb only) is not so tempting to them. So I’m asking for ideas around this.
Avocados, mushrooms, olives and nuts seems like reasonable items for vegans and those intolerant to egg & dairy.
Good day Sebastian!
How can a high fiber diet be called a “low carbohydrate” diet?
Is fiber no longer a carbohydrate?
Wouldn’t it be more honest to call a low sugar diet a “low glycemic” diet?
Haha, well, true, but I think there is general agreement that when people say low carb they mean low in digestible carb. A carb that goes straight through your body and out the other end isn’t a carb you need to be too concerned about!
Well, then the next question. It is known that starch, which is consumed in conjunction with fats and vegetables, as well as whole grains wrapped in their own shell, create a lower glycemic load than naked carbohydrates. Should we worry about these carbs?
Just watched this Low Carb Cure and on your recommendation I read Malcolm Kendricks’ The Clot Thickens. I am a confused mess. I have slightly high sugars which seems to be stuck in the high zone of 125. My family doctor says stop eating pasta and breads sugars carbs and fruits. My cardiologist ( I don’t have a heart condition) tells me to stop eggs , meats and cheeses and go mostly vegetarian and stop alcohol. Somehow I feel like there is nothing left for me to eat or enjoy.
Your family doctor seems like a very sensible person.
Your family doctor agrees with my mum – be wary of pasta. Shrewd wee woman, my mum.
Your cardiologist seems to be pushing a discredited notion. Rule of thumb: government health propaganda is likely to be wrong. We’d all like to think that our doctors inspect such propaganda with a keen critical intelligence. It’s because they don’t that we have to seek out such docs as Rushworth and Kendrick on the internet, bless them.